The comments, delivered during an earnings call in which UnitedHealth reported $14 billion in 2024 net income, laid out the company’s vision and viewpoints on its role in the American healthcare system.

The task in front of the company—as well as for “health care providers, payers, employers, drug companies and policymakers,” Witty said, according to an official transcript of the call, “is to continue improving quality and health outcomes for individuals and their families, while lowering costs for everyone.”

The comments came amidst a time of deep distrust of American health insurers—with many expressing support for Thompson’s shooter Luigi Mangione—as well as a Federal Trade Commission report revealing that United severely overcharged cancer patients for life-saving drugs. 

“We need to build on the unique foundational strengths of health care in America and address the areas we can make work better,” Witty, who was Thompson’s boss, said during the call. He noted that a U.S. strength has been to develop “the most advanced clinical approaches and patient-centric care at a pace not seen anywhere else,” which is why, “if provided with the option, people from all over the world come here to seek care for the most complex conditions.”

And yet, he added, “the health system needs to function better,” suggesting that while the various “program structures” are better than a one-size-fits-all approach, the system “needs to be less confusing, less complex and less costly.”

Just like in the rest of the world, Witty explained, America faces a conundrum: having limited health-care resources to pay for an unlimited demand. 

“Every society wrestles with that issue and approaches it in various ways,” he said, noting this country has “incredible opportunities here to improve system performance” both from a care and a cost perspective. 

“The mission of this company, why we exist, is to improve the system for everybody and help people live healthier lives,” Witty noted. “That means getting more people into high-quality value-based care and keeping them healthy in the first place.”

Part of that is “continuing to invest in programs like Medicare Advantage, which by providing coordinated care to seniors is proven to deliver better health outcomes at lower cost to consumers and taxpayers compared to fee-for-service Medicare,” he said. “Seniors recognize that value, which is why the majority of them choose Medicare Advantage.”

Whatever care option they choose, “People’s health interaction should be as intuitive and seamless as every other aspect of their lives—banking, shopping, streaming.” 

It’s why the company will be speeding up turnaround times “for approval of procedures and services for Medicare Advantage patients and to materially reduce the overall number of prior authorizations used for certain MA services,” Witty said, adding, “Ultimately, improving health care means addressing the root cause of health care costs.”

Health care is so expensive in this country, he explained, “because the price of a single procedure, visit or prescription is higher here than it is in other countries. The core fact is that price more than utilization, drive system costs higher. Tackling that problem will require all parts of the system and policymakers to come together.”

He also addressed the issue of the “persistently high cost of drugs in the U.S.,” leaving consumers, employers and public agencies to pay disproportionately more than those in other countries. 

“Just look at GLP-1 prices,” he said. “One drug, which costs $900 in the U.S. costs about one-tenth of that in Europe. Pharmacy benefit managers play a vital role in holding those prices down, which is why drug companies and their allies have spent the past several years attacking them.”

He credited United’s pharmacy service provider, OptumRx, for delivering “many tens of billions of dollars in savings annually versus the pricing set by the manufacturers, including on the GLP-1s. That sharply reduces the gap versus other countries, but even then prices in the U.S. are still multiples of what the rest of the world pays for the same drugs.”

He then mentioned some of the challenges the company has navigated over the past year, including the  Change Healthcare cyberattack, which has been called “the most significant and consequential cyberattack on the U.S. heath-care system in American history.

”Still, he said, “We’re invigorated by the path ahead. There are so many areas that can be enhanced, reworked, reengineered or even scrapped to make the health system work better as we know it needs to. That is both our responsibility and it’s our passion.”